Objective To investigate the biomechanical effects of the medial protrusio technique on the acetabular cup in adult patients with developmental hip(DDH)after total hip arthroplasty.Methods The CT scanning data of bilateral hips from an adult patient with unilateral DDH were obtained further to develop a finite element model of the affected hemipelvis.The medial protrusio technique with various levels of medial protrusio was simulated,and the biomechanical differences between the medial protrusio and non-protrusio groups were evaluated.Results In the simulated pull-out test,the maximum anti-pull-out load strength of the non-protrusio group was 1 166 N.Compared with the non-protrusio group,the anti-pull-out load strength of the 4 mm and 8 mm medial protrusio groups increased by 45.8％and 57.1％,respectively.The peak micromotion at the cup-bone interface for the non-protrusio group was 166.4 μm in the standing phase of the gait cycle,and that of the 4 mm and 8 mm medial protrusio groups was decreased by 46.2％and 62.1％,respectively.Regarding the immediate stress distributions of periacetabular bone tissues following cup implantation,the differences between the groups were not significant.Under the loading condition of the standing phase,the non-protrusio group yielded the lowest average and peak stresses.The average stress increased with the level of medial protrusio,and the highest peak stress was observed in the 4 mm medial protrusio group.Conclusions The medial protrusio technique can improve the initial stability of the acetabular cup,and the initial stability is positively proportional to the protrusio level.However,owing to the concentration of marginal stress at the cup-bone interface,a minor medial protrusio cup with insufficient bone coverage might increase the risk of various prosthesis-related complications.

Objective:To explore the clinical and pathological features of drug-induced liver injury (DILI) due to non-steroidal anti-inflammatory drugs (NSAIDs).Methods:The medical records of patients with discharged diagnosis of drug-induced liver injury, which were searched from the Hospital Information System of Shijiazhuang Fifth Hospital from January 1, 2013 to December 31, 2016, were collected and analyzed retrospectively. The patients with DILI due to NSAIDs were enrolled into the NSAIDs group and the patients with DILI due to other drugs were enrolled into the control group. The general conditions, results of laboratory tests, and detection results of liver histopathology in patients in the 2 groups were recorded. The score of Roussel Uclaf Causality Assessment Method (RUCAM), clinical type and classification, pathological type and classification, and clinical outcome evaluation of the DILI patients in the 2 groups were performed according to the relevant standards by the members of research team.Results:A total of 385 patients were enrolled into the study, including 63 cases in the NSAIDs group and 322 cases in the control group. The differences of sexual distinction, age, and clinical manifestation were not statistically significant ( P>0.05 for all). The results of types and severity classification of DILI based on R value showed that the differences of the proportion of patients with different DILI types and classifications between the 2 groups were not statistically significant ( P>0.05 for all). Forty-one and 142 patients underwent liver biopsy in the NSNIDs group and the control group, respectively. The results of liver biopsy showed that the proportion of patients with type of vascular injury in the NSAIDs group was significantly higher than that in the control group [4.9% (2/41) vs. 0 (0/142), χ 2=7.003, P=0.049]; the incidences of inflammation in the portal area and proliferation of bile duct in the NSAIDs group were statistically lower than those in the control group [(63.4%(26/41) vs. 93.7%(133/142), χ 2=25.544, P<0.001; 43.9%(18/41) vs. 76.1%(108/142); χ 2=15.337, P<0.001]; the incidence of hepatocyte steatosis in the NSAIDs group was significantly higher than that in the control group [22.0% (9/41) vs.9.2% (13/142), χ 2=4.925, P=0.026].After drug withdrawal and symptomatic treatments, differences in effective rate and recovery rate between the NSAIDs group and the control group were not statistically significant[88.9% (56/63) vs. 92.5% (298/322); 41.3% (26/63) vs. 52.5% (169/322), P>0.05]. There were no death in both groups. Conclusions:The clinical manifestations and clinical outcomes of patients with DILI due to NSAIDs were similar to those due to other drugs. The pathological characteristics of liver were that the incidence of inflammation and proliferation of bile duct in the portal area was lower than that of other drugs, and the incidence of hepatocyte steatosis was higher than that of other drugs. Vascular injury was also observed.

Objective:To explore the clinical and pathological features of drug-induced liver injury (DILI) due to non-steroidal anti-inflammatory drugs (NSAIDs).Methods:The medical records of patients with discharged diagnosis of drug-induced liver injury, which were searched from the Hospital Information System of Shijiazhuang Fifth Hospital from January 1, 2013 to December 31, 2016, were collected and analyzed retrospectively. The patients with DILI due to NSAIDs were enrolled into the NSAIDs group and the patients with DILI due to other drugs were enrolled into the control group. The general conditions, results of laboratory tests, and detection results of liver histopathology in patients in the 2 groups were recorded. The score of Roussel Uclaf Causality Assessment Method (RUCAM), clinical type and classification, pathological type and classification, and clinical outcome evaluation of the DILI patients in the 2 groups were performed according to the relevant standards by the members of research team.Results:A total of 385 patients were enrolled into the study, including 63 cases in the NSAIDs group and 322 cases in the control group. The differences of sexual distinction, age, and clinical manifestation were not statistically significant ( P>0.05 for all). The results of types and severity classification of DILI based on R value showed that the differences of the proportion of patients with different DILI types and classifications between the 2 groups were not statistically significant ( P>0.05 for all). Forty-one and 142 patients underwent liver biopsy in the NSNIDs group and the control group, respectively. The results of liver biopsy showed that the proportion of patients with type of vascular injury in the NSAIDs group was significantly higher than that in the control group [4.9% (2/41) vs. 0 (0/142), χ 2=7.003, P=0.049]; the incidences of inflammation in the portal area and proliferation of bile duct in the NSAIDs group were statistically lower than those in the control group [(63.4%(26/41) vs. 93.7%(133/142), χ 2=25.544, P<0.001; 43.9%(18/41) vs. 76.1%(108/142); χ 2=15.337, P<0.001]; the incidence of hepatocyte steatosis in the NSAIDs group was significantly higher than that in the control group [22.0% (9/41) vs.9.2% (13/142), χ 2=4.925, P=0.026].After drug withdrawal and symptomatic treatments, differences in effective rate and recovery rate between the NSAIDs group and the control group were not statistically significant[88.9% (56/63) vs. 92.5% (298/322); 41.3% (26/63) vs. 52.5% (169/322), P>0.05]. There were no death in both groups. Conclusions:The clinical manifestations and clinical outcomes of patients with DILI due to NSAIDs were similar to those due to other drugs. The pathological characteristics of liver were that the incidence of inflammation and proliferation of bile duct in the portal area was lower than that of other drugs, and the incidence of hepatocyte steatosis was higher than that of other drugs. Vascular injury was also observed.

Objective To investigate softening-hardness dissipating-binds effects of Fuzheng Huayu (reinforcing-healthy qi resolving-stasis)Tablet combined with anti-virus therapy on liver fibrosis, and relationship between these effects and regulation of pathway of miR-122-interleukin-10-reactive oxygen species(miR-122/IL-10/ROS).Methods The patients with chronic hepatitis and liver fibrosis(n=85)were chosen from Aug.2015 to Aug.2016,and then divided randomly into test group(n=45)and control group(n=40).The control group was treated with entecavir(0.5 mg/d)and monoammonium glycyrrhizinate(0.1 g/d),and test group, additionally with Fuzheng Huayu Tablet(4.5 g/d)for 48 weeks.After treatment,ISHAK fibrosis score was reviewed through routine pathology, and activities of serum superoxide dismutase(SOD)and ROS were detected by using ELISA.The expressions of miR-122 mRNA and IL-10 mRNA were detected by using RT-PCR, and content of serum inflammatory factors of liver fibrosis, including procollagen III N-terminal peptide(PCIIINP), type IV collagen(IV-C), hyaluronidase(HA)and laminin(LN),were detected by using immunoturbidimetry.Results ISHAK fibrosis score had no significant difference between 2 groups before treatment,and decreased in 2 groups after treatment,which was superior in test group to that in control group(P<0.05).The content of serum inflammatory factors of liver fibrosis all decreased in 2 groups after treatment,and the decreases of PCIIINP and HA were more significant in test group compared with control group(P <0.05).The activities of ROS and SOD had no difference in 2 groups before treatment,and ROS decreased in 2 groups after treatment.The inhibitory effect on ROS was better in test group than that in control group after treatment(P<0.05), and SOD increase was effectively relieved in test group after treatment(P <0.05).The expressions of miR-122 mRNA and IL-10 mRNA all decreased in 2 groups after treatment, which was more significant in test group compared with control group(P<0.05).Conclusion Fuzheng Huayu Tablet reduces directly the levels of collagen and HA, degrades abnormal deposition of extracellular matrix,and regulates dynamic balance of collagen,and it antagonizes effectively the genetic expressions of IL-10 and miR-122,relieves inflammatory disorders and controls progress of histology.

Objective To explore the impact of different presentations on the image understanding of children with autism. Methods From November, 2016 to March, 2017, 30 pupils with autism aged seven to 14 years in the special education school were observed the understanding of picture, in term of characters, continuations and sequences, and their focus was recorded with the eye tracker. Results The comprehension score was the highest for the picture with cartoon characters, continuous and non-sequential (F=9.99, P<0.001). There was no correlation between the distribution of the focus and comprehension rate (r=0.27, P>0.05). Direct or indirect experience and omiting content did not impact the comprehension rate (t<1.522, P>0.05).Conclusion Compared with strange photos, images of fixed cartoon characters are more conducive to understand for children with autism. Disrupting the order of the picture and omitting some of the sequence do not affect the understanding, which is consistent with the theoretical hypothesis of central insufficiency.

Vanishing bile duct syndrome (VBDS) manifests as progressive destruction and disappearance of the intrahepatic bile duct caused by various factors and cholestasis. VBDS associated with drug-induced liver injury (D-VBDS) is an important etiology of VBDS, and immune disorder or immune imbalance may be the main pathogenesis. According to its clinical symptoms, serological markers, and course of the disease, D-VBDS is classified into major form and minor form, and its clinical features are based on various pathomorphological findings. Its prognosis is associated various factors including regeneration of bile duct cells, number of bile duct injuries, level and range of bile duct injury, bile duct proliferation, and compensatory shunt of bile duct branches. This disease has various clinical outcomes; most patients have good prognosis after drug withdrawal, and some patients may experience cholestatic cirrhosis, liver failure, and even death. Due to the clinical manifestation and biochemical changes are similar to the primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC), it need to identify by clinical physician.

Objective To evaluate the clinical efficacy and safety of integrated traditional Chinese and Western medicine in treating active rheumatoid arthritis (aRA).Methods A prospective randomized controlled study was carried out. Totally 148 aRA patients were divided into the control group and the treatment group, 74 cases in each group. Control group was treated with MTX (methotrexate) and LEF (leflunomide), while the treatment group took traditional Chinese medicine based on syndrome differentiation, on the basis of treatment with MTX and LEF. The therapeutic course for all was 3 months. Efficacy indexes, like clinical symptoms and signs, ESR, TCM syndrome integrals, DAS 28 score, and safety indexes were observed.Results This study finally completed 136 cases, including 69 cases in the treatment group and 67 cases in the control group. In the two groups, significant improvement of clinical signs and symptoms, ESR, DAS28, and TCM syndrome integrals after treatment were shown, with statistical significance (P<0.01). Better effects were obtained in the treatment group in lessening tender joint numbers and swollen joint numbers, DAS28, and TCM syndrome integrals (P<0.01). The total effective rate of the TCM syndrome efficacy was 86.96% (60/69) in the treatment group, and 76.12% (51/67) in the control group, without statistical significance (P>0.05). The significant efficiency of the treatment group was 11.59% (8/69), and the control group was 5.97% (4/67), with statistical significance (P<0.05). Adverse reactions occurred fewer in the treatment group than in the control group (P<0.01).Conclusion Compared with single traditional Chinese medicine, integrated traditional Chinese and Western medicine for treating aRA can better improve DAS28 and TCM syndrome integrals, and reduce the incidence of adverse reactions.

Objective To investigate the charactoristics of comprehension of words or phrases of nouns in chidren with autism. Meth-ods From November, 2014 to April, 2015, 43 children with autism and 10 with Down's syndrome aged 7-14 years accepting special educa-tion, and other 42 normal children aged 7-8 years were asked to identify the pictures according to the words, wearing Tobii Ⅱ Glasses to re-cord eyes movement. Results The incidence of right answer was more in the normal children than in the ones with autism or Down's syn-drome (χ2>5.647, P<0.05), and more focused on the right pictures (χ2>6.248, P<0.05). For the phrases, the children with autism tended to fo-cus on the words as the order of speech, but not the center word (χ2>7.15, P<0.05). For the words, the first views after questions were differ-ent from the children with autism to the normal children (χ2>5.04, P<0.05). Conclusion Children with autism tend to focus on the words as the order of speech, but not the center word, which may influence the phrases understanding, and be influenced by the intuitive vision.

On the basis of pre-experiment research and the hypothesis of“amputated lumbricus”, this research was aimed to explore mechanism of active components of the amputated lumbricus to promote wound healing. Skin excision was used to establish the mice model. The amputated lumbricus extract was prepared. HE staining and immunohistochemistry techniques were used in the determination of the wound healing rate and changes of VEGF, bFGF, TGF-β1 expression during wound healing period. The results showed that compared with the blank control group, the healing rate of the amputated lumbricus extract group was better. And the HE staining showed better improvement of traumatic tissues. There was no statistic differences on the expression of VEGF and TGF-β1 between the amputated lumbricus extract group and the normal saline group (P> 0.05). The expression of bFGF in amputated lumbricus extract group reached peak earlier than the control group and also lasted a longer time. The amputated lumbricus extract group reached peak on the first day, which had a significant difference (P < 0.05) compared with the control group at the same timepoint. It was concluded that the external application of amputated lumbricus extract had wound healing effect on traumatic skin of mice. Its mechanism may be irrelevant to the expression of VEGF and TGF-β1. However, it may be related to the increasing of bFGF expression in the injured regions during the inflammation stage and proliferation stage.

Objective To investigate whether lipids and reagents would interfere the results when serum total bile acid(TBA) was measured by enzymatic cycling assay.Methods The serum TBA was measured by enzymatic cycling assay.The carry-over contaminations of high density lipoprotein(HDL-C),low density lipoprotein(LDL-C),cholesterol(TC),and triglyceride(TG)rea-gents were evaluated.In order to reduce the interference and carry-over contaminations,different washing procedures and detection sequence were set.Results By measuring the levels of TBA in pooled serums with low and high levels of lipids,the results showed that there was statistically significant difference between the groups with and without the addition of cleaning process before and af-ter TBA measurement(P <0.01).Cleaning with water might be more effective on reducing interference than those with acid solu-tion.Moreover,the mean of TBA levels in HDL-C,TC,TG and LDL-C reagents were (476.06 ± 1.88 ),(127.78 ± 1.18 ), (121.05±1.08),and (2.23±0.51)μmol/L,respectively.The stability of TBA level was greatly affected by HDL-C regents,fol-lowing by TC and TG reagents,and was little affected by LDL-C reagent.Setting up proper detection sequence and flushing proce-dures could obviously reduce the interference(P <0.01),but not completely rule out.Conclusion Analysis sequence and flushing procedures of biochemical analyzer as well as exogenous substance from reagents may seriously affect the accuracy of determination results.To ensure the accuracy and reliability of the results,it is necessary not only to set up reasonable irrigation and reaction se-quence,but also to master the instrument operation,to know the principle of test reaction and the components of reagents as well as equipment maintenance.